As my husband and I watched our baby moving on the sonogram screen before us, hearing the familiar fluttering that seemed to fill the dark room, we found it nearly impossible to digest what the specialist had just told us. “I advise that you terminate this pregnancy.”
This is my PPROM story.
During National Prematurity Awareness Month I want to share what every woman of child-bearing years needs to know about it.
What is PPROM?
Preterm Premature Rupture of Membranes (PPROM) occurs when the amniotic sac breaks way too early (technically before 34 weeks). Mine broke just before 14 weeks. Yes, you read that correctly. 14 weeks.
Actually, I didn’t even know my water had broken. It wasn’t a huge gush of fluid like you experience with full-term pregnancies; the only symptom I had was faint spotting one night which, of course, led to fears of a miscarriage.
So when my husband I went to my OBGYN the next day, and he told me there was a heartbeat, I was elated. But what he said next changed my world forever: “But there’s no amniotic fluid.”
My sweet doctor was very calm, assuring me it was nothing I did to cause this (it happens in about 3% of pregnancies). He advised me to go home and get in the bed for a week because in some rare cases the amniotic sac will reseal on its own.
I didn’t have the heart to ask him what happened if it didn’t…
“I love the Lord, for he heard my voice; he heard my cry for mercy. Because he turned his ear to me, I will call on him as long as I live.” Psalm 116:1-2
The Standard Medical Response
Fast forward a week and we found ourselves at the high-risk specialist’s office. Our hopeful spirits were crushed when he told us that the sac did not reseal.
He then proceeded to explain to us that just like when your water breaks at full-term you are told to go to the hospital because the risk of infection is high. Well, that same risk of infection is present when your water breaks extremely early.
The amniotic sac is what protects the baby from bacteria and infection. As soon as it is breached it is not a matter of if an infection will come but when. And when it does, the infection quickly spreads to the mother, who if not treated quick enough, could die from sepsis.
Besides, the doctor told us, amniotic fluid is what develops a baby’s lung tissue. Even if by some miracle this baby made it to viability (23-24 weeks) without getting an infection, he told, there would no way the baby could breathe upon birth. He/she would suffer and suffocate within a few minutes after birth.
And if by some miracle of miracles he or she didn’t die upon birth she would be horribly disabled (amniotic fluid is what allows babies’ muscles to move and develop properly) and hooked up to a ventilator, and probably be brain damaged (due to the placental abruption not allowing blood to flow properly to the baby) the rest of his/her life.
Another caveat (that doesn’t happen with all PPROM pregnancies but to some), the placenta was 50% abrupted, meaning the baby was being deprived of proper nutrients and oxygen. The amniotic sac was no longer filled with water, but with blood.
“The cords of death entangled me, the anguish of the grave came over me;
I was overcome by distress and sorrow. Then I called on the name of the Lord:
“Lord, save me!” Psalm 116: 3-5
There is nothing to prepare you as expectant parents for this kind of news. But seeing the baby on the screen, hearing the heartbeat pumping away, I could do not as they advised.
The specialist and his partner did not agree with our decision. But they hesitantly said I could go home, get in the bed, and wait to get an infection as long as I agreed to take my temperature several times daily. If I started showing signs of a fever they would absolutely have to deliver the baby because that meant certain morbidity for an under 24 weeker and it was only a matter of time before I would get the infection, too.
“Pray for a miracle,” one of the doctors said as we walked out, my husband having to hold me up as the weight of the news was almost too much to bear.
“The Lord is gracious and righteous; our God is full of compassion. The Lord protects the unwary; when I was brought low, he saved me.” Psalm 116:5-6
A Glimmer of Hope
In our modern age, there seems to be few conditions or diseases without some sort of treatment, medicine, or medical trial. But that’s the case with PPROM, as our friends and family soon learned when they started researching where else we could go or what else we could do to help this baby. Many things have been tried – patches and injecting of synthetic fluid – but all have been proven to increase infection rates and thus mortality.
But then I came across a small glimmer of hope.
I found an international PPROM message board (that’s now a Facebook group and website called Little Heartbeats). Some of the women on the message board were on bed rest like me and were also told that their baby wouldn’t survive. Others had recently terminated their pregnancies upon the advice of their doctors and were seeking support and answers after their devastating losses.
And then there were a few women on the board whose PPROM babies had survived. Granted, their water didn’t break as early as 14 weeks like mine.
But the mother who said her water broke at 18 weeks and posted pictures of her then two-year-old gave me the little hope I needed to get through each day. That and my belief in God who heals, who isn’t limited by doctors’ predictions or harmful bacteria or my compromised womb. I didn’t know if he would heal her, but I knew that he could and would if it is was His will to do so on this earth.
“Return to your rest, my soul, for the Lord has been good to you.” Psalm 116:7
So on bedrest I stayed. I made it through the first week, then the second. I held my breath every time we drove to the doctor for a checkup. Every bump in the road felt like it could send me into labor. And every time the doctor put the sonogram wand on my growing belly I wondered: would there be a heartbeat this time? I was just as shocked as the doctor when that familiar, fast beat appeared on the screen.
I spent 15 weeks on strict bed rest with no measurable amounts of amniotic fluid, the last six in the hospital on the antepartum ward. During the time I only got out of the bed to go to the bathroom and take an occasional shower. I am not going to lie – it was the most difficult thing I’ve ever done in my entire life.
Most women on the antepartum ward were guaranteed a baby in the end if they just followed the doctors’ orders. I was doing all this but being told day in and day out that my baby was probably going to die at the end . . . and, hopefully, I wouldn’t either.
I spent my days in the Word, feeling my baby’s kicks and hiccups, and praying. I had no desire to watch t.v. or barely even read. Given no earthly hope for healing, the only comfort I had was the presence of the Lord in tiny hospital room. No doubt He sustained and lifted me up as I was in the depths of despair. He used friends’ letters and messages to encourage me and elders from our church prayed over me almost daily. With the support of my husband, mom (who practically moved in with us) and family, I was able to focus on keeping still, both mind and body.
I held onto my hope in miracles, checking that message board every day for more stories of survival, stories of PPROM babies defying doctors’ expectations. Many of them died, but there were stories of survival. And that kept me going in the toughest of days and nights.
“Arise, cry out in the night, at the beginning of the night watches! Pour out your heart like water before the presence of the Lord! Lift your hands to him for the lives of your children, who faint for hunger at the head of every street.” Lamentations 2:19
I finally went into labor at 29 weeks, 15 weeks after my water broke, most likely due to an infection but also because the placenta starting pulling away from the wall of the uterus.
It was an emergency situation as I had been told it probably would be. Most women are knocked out completely for emergency c-sections but I asked my doctor to keep me awake (still numb) if at all possible.
If my baby was only going to live a few minutes, I wanted to be awake for it. I’ll never forget the nurses rolling me quickly back to the ER and my mom looking at me like she didn’t know if she would ever see me again. But I had a peace that surpasses understanding about me. I wanted to meet the baby that I had bonded with in those otherwise lonely 15 weeks of bed rest.
“For you, Lord, have delivered me from death, my eyes from tears,
my feet from stumbling, that I may walk before the Lord in the land of the living.” Pslam 116:8-9
They never put my baby on my chest to die, as I had feared would happen. In my foggy state, I saw them pull the baby out of me and take her to a little room off the side of the OR.
The next thing I remember they were wheeling her out of the room, five or six nurses and doctors hovering above and around her, pumping and administering medicine. They didn’t stop to let me see her and I was so grateful.
That little hospital bed whizzing out of the room meant that she going to the NICU and they were going to do at least try to work on her, instead of putting her on me to say good-bye.
“What shall I return to the Lord for all his goodness to me? ” Psalm 116:12
The NICU and Beyond
The first few hours and days were touch and go. At one point, the NICU doctor told my husband we needed to say our goodbyes. But our daughter kept defying odds, hanging on. They put her on a high oscillating ventilator, gave her as many steroid shots as she could take, and everything else they could possibly do to get her lungs to function.
Our daughter spent a total of 2 and a half months in the NICU, which is very little time considering her story. When we left the NICU, doctors did not know what her life would look like. Would she ever talk? Walk? She came home on oxygen and had a feeding tube for several years.
I will not brush off the fact that those early years were difficult. Doctors didn’t know how to treat her because there aren’t many babies that survive what she did. We saw many specialists for many years. She had to have multiple surgeries for congenital issues (from the lack of fluid) and our weeks were spent doing physical, occupational and speech therapy. We had full time nursing care because her needs were so big.
But it was all worth it.
The bed rest, the trauma, the sacrifices my husband and other children have made so I could devote time to helping her live the best life she can live. The fact that I had an opportunity to do all these things is an answer to prayer.
It was a long road but today she is a happy, vibrant, and joyful 10-year-old girl, going to a rigorous academic school, playing basketball and soccer, and defying everything doctors told us what happened to her.
Her story is a story of healing and hope. And I so honored to share it with you today.
“I will lift up the cup of salvation and call on the name of the Lord. I will fulfill my vows to the Lord in the presence of all his people.”Psalm 116:13-14
I realize my daughter’s story of survival after a PPROM and placental abruption at 14 weeks is rare. In fact, I think it is a miracle. I no longer use the word miracle lightly.
But even to this day women who PPROM much later – at 18,19, even 22 weeks – are often advised to terminate even though they are just weeks away from what is considered viability (22-24 weeks depending on the country). They aren’t told of the many success stories out there, which is why I am highlighting this condition on my platform. Women deserve to know about the success stories in addition to the risks.
Yes, they are all premature babies (women with PPROM aren’t advised to go full term because the risk of infection is believed to increase after 34 weeks), but a premature baby is better than no baby.
Looking back on the recommendation to terminate, I realize things could have turned out differently. The outlook was grim. Had she died during birth or shortly thereafter would I feel differently about the path we took? I don’t think I would.
I knew what was medically supposed to happen but during those 15 weeks of bed rest I had a deep longing to see and hold my baby, even if only for a few minutes.
But she lived for more than a few minutes. You see, only God knew the outcome of this story, of His story really.
And I’m so glad I waited for it to unfold.
What You Can Do
So I humbly ask you to share this with post with your friends. Not to post about a scary pregnancy, but perhaps there is a pregnant mom out there who has just received the most devastating news, and she is scrolling through google search results for any glimmer of hope or support. I would love for our story to be that glimmer of hope and perhaps get the medical community to relook its standard response to this medical condition.
If you’d like to learn more of our story I recorded a video on Instagram.
I love the Lord, because he has heard
my voice and my pleas for mercy.
2 Because he inclined his ear to me,
therefore I will call on him as long as I live.
3 The snares of death encompassed me;
the pangs of Sheol laid hold on me;
I suffered distress and anguish.
4 Then I called on the name of the Lord:
“O Lord, I pray, deliver my soul!”
5 Gracious is the Lord, and righteous;
our God is merciful.
6 The Lord preserves the simple;
when I was brought low, he saved me.
7 Return, O my soul, to your rest;
for the Lord has dealt bountifully with you.
8 For you have delivered my soul from death,
my eyes from tears,
my feet from stumbling;
9 I will walk before the Lord
in the land of the living.
10 I believed, even when[a] I spoke:
“I am greatly afflicted”;
11 I said in my alarm,
“All mankind are liars.”
12 What shall I render to the Lord
for all his benefits to me?
13 I will lift up the cup of salvation
and call on the name of the Lord,
14 I will pay my vows to the Lord
in the presence of all his people.
15 Precious in the sight of the Lord
is the death of his saints.
16 O Lord, I am your servant;
I am your servant, the son of your maidservant.
You have loosed my bonds.
17 I will offer to you the sacrifice of thanksgiving
and call on the name of the Lord.
18 I will pay my vows to the Lord
in the presence of all his people,
19 in the courts of the house of the Lord,
in your midst, O Jerusalem.
Praise the Lord!